Active NPI
Diego Ignacio Fernandez Vial, DDS MS
- Orofacial Pain Dentistry
- Houston, TX
National Provider Identifier
1558049387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orofacial Pain Dentistry
- License
- 39810
- Practice address
- 12626 Woodforest Blvd Ste Z
Houston, TX 77015-3653 - Phone
- (171) 359-0099
- NPI assigned
- Jul 11, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orofacial Pain Dentistry | 1223X2210X | 39810 | TX | Primary |
Addresses
Primary practice location
12626 Woodforest Blvd Ste Z
Houston, TX 77015-3653
Mailing address
1916 W Gray St Apt 240
Houston, TX 77019-4834
Phone (859) 382-3910
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39810 | TX | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690934400000",
"number": "1558049387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1916 W GRAY ST APT 240",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770194834",
"telephone_number": "859-382-3910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12626 WOODFOREST BLVD STE Z",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770153653",
"telephone_number": "171-359-0099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ VIAL",
"first_name": "DIEGO",
"middle_name": "IGNACIO",
"credential": "DDS MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-07-11",
"last_updated": "2023-08-02",
"certification_date": "2023-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223X2210X",
"taxonomy_group": "",
"desc": "Dentist, Orofacial Pain",
"state": "TX",
"license": "39810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
- Reinney Fernandez Estrada, RN
- Yenier Fernandez Estrada, SONOGRAPHER
- Angel Mario Fernandez Flores, LPC
- Josaura Vanessa Fernandez Sanchez, M.D.
- Aurora Fernandez Sordelli, DDS, MSD
- Higinio Fernandez-Sanchez, PHD, RN, FAAN
- Luis Alejandro Fernandez-Wische, M.D.
- Alexandra Fernandez, MS, RDN, LD
- Amanda Fernandez, M.S., CCC/SLP
- Ann Marie Fernandez, DO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.